Happy One-Year to Me and OC

I find it rather hard to sit down and write this final blog post. While this may be a result of my impressive procrastination skills or of the busy-ness brought on by the summer months, I believe what makes it so difficult is that it requires me to admit that my fellowship is nearing its end. It requires me to not only reflect upon my experiences this past year, but to embrace change and its accompanying uncertainties. It also reminds me of the people I am thankful for – my supervisor and coworkers at OrthoCarolina, the Davidson support system, my mentors and my friends – and that I have a lot still left to learn.

For this post, I am going to format it as a triple-entry journal. Several weeks ago we (the Impact Fellows) had our last conference call and discussed the importance of learning through reflection so it seems fitting now to employ such a technique. I am going to respond to the questions posed by the article we reviewed. (As the reader, you might appreciate the structure and focus it hopefully adds to my writing).

Observation. My fellowship began with OrthoCarolina (OC) at a unique time in U.S. healthcare. In 2010 the Affordable Care Act (ACA) was signed into action, and with it came an abundance of regulation seeking to improve quality, lower costs, increase access to affordable care and even transition the physician payment model from one based on volume, to value. Everything proposed in the legislation is of course well-intended, but carrying it out for individual healthcare organizations has proved much easier said than done.

As a physician-led organization; however, OC has been quick to respond to and implement these changes. And while working for the department at OC designed to facilitate these changes, I have watched OC grow over the course of this year… So much so that its leaders now mentor other orthopedic groups making similar changes. How cool.

Connection. That, however, is the view “from the hill” of my work this year. As I discussed in my previous blog post changing healthcare on a micro-level calls for massive shifts in culture and individual interactions, which is no easy feat. Most of the past connections I can make here have to do with my experiences as a patient, but also my experiences abroad. My independent research examining low-income access to healthcare in Tokyo, my assistantship in a maxio-facial surgery department in Germany, and my volunteer work in a regional hospital in Tanzania, together have helped me develop a critical eye for examining differences in healthcare institutions and their overall structure. I think it is the culmination of these experiences that have helped me to better analyze the challenges organizations like OC face to keep patients at the center of care while evolving standards that provide the best care at the lowest cost.

Personal relevance. I started at OC a year ago with the overarching goal of better understanding the U.S. healthcare system. And while I do have a better grasp of the influences on hospital decisions and patient care – federal programs, health policy, scientific research, individual physician practices, etc. – it is such a confusing and complex process. I believe it is this confusion; however, that pushes me to want to better understand and help to improve the healthcare system.

I am excited to say that I will be building upon this knowledge even after my fellowship ends. Next year I will be heading to Boston University School of Public Health. It is my hope that I can take the knowledge I will learn and apply it in my role as a healthcare provider one day and become a positive influence on the choices and decisions that make up the healthcare system as it continues to evolve.

This year, my Impact Fellowship with OC has helped me to grow professionally, personally and has continued to fuel my motivations and passions for making a difference in this world. I could not have asked for a more fulfilling “first year in the real world”. And to everyone who has made this experience possible, thank you.